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COMMUNITY-BASED OVERDOSE RESPONSE NETWORKS

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Improving access to naloxone for active opioid overdoses

While communities around the country are handing out naloxone to anyone willing to step up and reverse an overdose, the only people who get alerted when an overdose is reported to 911 are police, fire and EMS. We’re here to change that.

The Beacon Emergency Dispatch platform alerts community responders equipped with Naloxone when active opioid overdoses are reported in their area.

Beacon can be used as a standalone dispatch platform or it can be easily integrated into the local 911 call center.

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60 Overdoses in 30 Days: At Work With the Connecticut Harm Reduction Alliance

After only the first 30 days of the program, CTHRA street outreach workers had already responded to over 60 overdoses, arriving on-scene on average in less than 6 minutes — and very often before formal emergency responders.

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Community Responders In Puerto Rico Reverse Opioid Overdoses With Naloxone And Simple Text Message Alerts

With just two simple text message alerts, community responders in rural Puerto Rico were able to locate an overdose victim and save their life.

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We do. Calling 9-1-1 is the best way to call for help in case of an emergency. We see this program as a “both/and” solution: “Call 9-1-1 and dispatch community responders.” There simply aren’t enough ambulances, fire engines and police cruisers to respond to every single overdose quick enough to reduce fatal opioid overdoses to 0 – which is our end goal. Some other considerations:



Frequency and rates of opioid overdoses have increased dramatically since 2000, taxing many local emergency response systems to breaking point. We believe that community responders can work in parallel with formal 9-1-1 responders.
 
In many rural communities, response times for formal 9-1-1 responders are too long. Using community responders helps reduce response times dramatically.
New forms of naloxone, such as Narcan®, make it easier for non-medical professionals to effectively learn how to administer a life-saving dose in time to save a life.
In some communities, witnesses to opioid overdoses are reluctant to call 9-1-1 for fear of legal repercussions or their own safety. Knowing that community responders with “lived” and “learned” experience with substance use disorder would also be responding could help to mitigate those fears.

Hopefully this is never the situation. If it is, we still propose that it should be a “both/and” proposition and not “either/or”. If the situation is such that 9-1-1 isn’t available quick enough, additional contact points for finding community responders with naloxone will increase the likelihood of overdoses being reported while filling in the gaps among belabored emergency services.

Because we see these community-based networks as a “both/and” solution, if community responders don’t show up, it’s ok because a 9-1-1 response has already been activated. Nonetheless, getting community responders to show up when they’re alerted is crucial, and it’s also a challenge that volunteer emergency services across the U.S. solve every day. The solution comes down to strong leadership, having sufficient responders in a specific area, and aligned incentives. Sufficient numbers can be recruited and retained with a good strategy:

  • Recruit the right people – Ensure that potential responders are comfortable with a closeup look at opioid abuse and are properly trained in response protocols, such as administering naloxone=
  • Dispatch multiple responders – Create schedules for potential responders so two or more may be dispatched to a single incident
  • Offer incentives – Reward emergency responders and volunteers for their participation, keeping them active and evangelizing the strengths of the program

Naloxone is preferably administered by or with a medical professional, but this is not always possible nor is it even necessary.

  • Many areas with high opioid abuse do not have enough medical professionals to respond in time to save lives.
  • Research has found minimal risks associated with treatment followed by release.[1],[2]
  • Non-medical professionals can be trained to recognize factors besides opioid overdose at an incident, prompting calls to 9-1-1 or medical professionals.

[1] Rudolph SS, Jehu G, Nielsen SL, Nielsen K, Siersma V, Rasmussen LS. Prehospital treatment of opioid overdose in Copenhagen: Is it safe to discharge on-scene? Resuscitation. 2011;82(11):1414–8. [2] Wampler DA, Molina DK, McManus J, Laws P, Manifold CA. No Deaths Associated with Patient Refusal of Transport After Naloxone-Reversed Opioid Overdose. Prehosp Emerg Care. 2011;15(3):320–4.

The reality is that it’s impossible to completely guarantee 100% safety for responders, whether they’re professional emergency crews or community members. But we also think the safety concerns should be evaluate more by probability than possibility. Read this blog post to learn more.

Community-based overdose response networks with beacon

POTENTIAL OVERDOSE

A witness to a suspected opioid overdose knows there is naloxone available in the community and calls for help.

RESPONSE DISPATCH

A dispatcher receives the call from the witness requesting urgent naloxone delivery, enters the witness’ location into Beacon and sends it as an SMS text alert to all available community members equipped with naloxone.

Crisis Response

Community responders reply to the alert and Beacon determines the nearest and most appropriate resources and personnel to respond quickly. Responders get instructions to proceed to the incident location, with two or more dispatched for safety’s sake.

CONFIRM ON-SCENE

Responders locate the victim and update the dispatcher through Beacon, ensuring accountability and maintaining open communications should more resources be needed.

NALOXONE ADMINISTRATION

Responders determine if the scene is safe and then assess the patient for tell-tale opioid overdose symptoms. Naloxone is then administered to the victim. If the overdose is reversed, a life is saved. If there is no change in the victim’s condition, 9-1-1 is already en route.

INTERVENTION, TRANSPORT OR RELEASE

Where available, responders are able to offer referral services, counseling or transport to an appropriate medical facility. Or, as is so often the case after EMS reverses an overdose, the survivor leaves on their own.

Our articles on community-based Overdose response

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Beacon emergency dispatch is a cloud-based, do-it-yourself platform for emergency services that alerts, coordinates and tracks prehospital personnel using any mobile phone, with or without internet.

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